Prevalence and risk factors for human immunodeficiency virus–associated neurocognitive impairment, 1996 to 2002: Results from an urban observational cohort

Abstract Background People living with Human Immunodeficiency Virus (PLWHIV) under antiretrovirals have an increased risk of atherosclerotic cardiovascular disease (ASCVD) events. The risk factors associated with ASCVD events in this high risk population are various including traditional vascular risk factors and specific HIV-related factors. However their respective influence is questionable. Purpose Our aim was to determine the incidence of ASCVD events in a large cohort of PLWHIV and to identify the risk factors associated. Methods We conducted a longitudinal observational cohort study of asymptomatic PLWHIV at high risk of ASCVD addressed to our preventive cardiovascular unit for non-invasive cardiovascular evaluation. The first ASCVD event was censored and included CV death, acute coronary syndromes, coronary and peripheral revascularizations (PCI or CABG or endarterectomy or limb procedures) and ischemic strokes. Results From January 2003 to December 2014, 763 consecutive asymptomatic PLWHIV were enrolled (mean age of 51.3±8.3 years, 87% men, 90% were free of known coronary artery disease, mean Left ventricular ejection fraction 60%). At baseline, traditional CV risk factors were as follow: 54% had dyslipidemia, 43% hypertension, 35% were active smokers, 22% had family history of CAD and 11% were diabetics. Statins were prescribed in 38% of the cohort, aspirin in 14%, clopidogrel in 14% betablockers in 14%, RAS blockers in 32%, Calcium channel blockers in 8%. At baseline, median duration of HIV seropositivity was 19.8 years (14.0–23.6), 94% were under ARV predominantly protease inhibitors (68%). Median CD4 cell count was 545/mm3 (404–745) and 92% had undetectable HIV viral load. During a median follow up of 5.8 years (3.7–8.7), 58 (7.3%) subjects had a first ASCVD event (incidence of 12.70 [9.78–16.51] per 1000 persons-years) including 5 cardiovascular deaths, 14 ACS, 20 coronary revascularizations, 13 peripheral vascular procedures and 6 strokes) with a median time of occurrence of 3.1 years (1.5–5.1). CV death (first and second ASCVD events) occurred in 8 patients (22%) after CV death related to malignancies (33%) but before deaths related to unexplained causes (21%), infectious disease (13%), liver disease (8%) and suicides (3%). Coronary events including coronary death, MI, and coronary revascularization occurred in 39 patients (5.2%); Incidence of 8.28 [6.00–11.43] per 1000 persons-years. Conventional multivariate Cox model shows that age and tobacco were the independent risk factors associated with ACSVD events [Hazard ratio (HR) 1.04, 95% CI 0.99–1.09, p=0.05 and HR 2.17, 95% CI 1.07–4.38, p=0.03]. Conclusion Traditional vascular risk factors (age and active smoking) are associated with the occurrence of ASCVD events predominantly coronary artery disease in our observational cohort of asymptomatic PLWIHV at high risk for ASCVD. Cardiovascular prevention including tobacco cease action is mandatory in the aging HIV population.

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Prevalence of and Risk Factors for Low Free Testosterone Levels in Japanese Men with Well-controlled Human Immunodeficiency Virus Infection

Current HIV Research ◽

10.2174/1570162x18666200720000344 ◽

2020 ◽

Vol 18 (5) ◽

pp. 381-386

Author(s):

Yusuke Yoshino ◽

Ichiro Koga ◽

Yoshitaka Wakabayashi ◽

Takatoshi Kitazawa ◽

Yasuo Ota

Keyword(s):

Risk Factors ◽

Human Immunodeficiency Virus ◽

Standard Deviation ◽

Hiv Infection ◽

Free Testosterone ◽

Serum Levels ◽

University Hospital ◽

Rapid Decline ◽

Total Testosterone ◽

Immunodeficiency Virus

Background: The change in the prevalence of hypogonadism with age in men with human immunodeficiency virus (HIV) infection is subject to debate. Objective: To address this issue, we diagnosed hypogonadism based on serum levels of free testosterone (fTST) rather than total testosterone which is thought to be an inaccurate indicator. We also determined the relationship between age and fTST levels and identified risk factors for hypogonadism in men with HIV infection. Method: We retrospectively reviewed fTST levels and associated clinical factors in 71 wellcontrolled HIV-infected men who were treated at Teikyo University Hospital between April 2015 and March 2016 and who had data available on serum fTST levels, measured >6 months after starting antiretroviral therapy. fTST was measured using radioimmunoassay on blood samples collected in the morning. Risk factors for hypogonadism were identified using Welch’s t-test and multiple regression analysis. Results: The men had a mean (± standard deviation) age of 47.4 ± 13.6 years, and mean (± standard deviation) serum fTST level of 13.0 ± 6.1 pg/mL. Fifteen (21.1%) men had hypogonadism based on a fTST <8.5 pg/mL. Serum fTST levels significantly decreased with age (−0.216 pg/mL/year). Older age and low hemoglobin levels were identified as risk factors for hypogonadism. Conclusion: The men in the study experienced a more rapid decline in fTST levels with age than men in the general population (−0.161 pg/mL/year). Serum fTST levels in men with HIV infection should be monitored, especially in older men and those with low hemoglobin levels.

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Risk Factors for Unfavorable Treatment Outcomes among the Human Immunodeficiency Virus-Associated Tuberculosis Population in Tashkent City, Uzbekistan: 2013–2017

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094623 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4623

Author(s):

Sherali Massavirov ◽

Kristina Akopyan ◽

Fazlkhan Abdugapparov ◽

Ana Ciobanu ◽

Arax Hovhanessyan ◽

...

Keyword(s):

Risk Factors ◽

Human Immunodeficiency Virus ◽

Treatment Outcomes ◽

Sputum Smear ◽

People Living With Hiv ◽

Tb Treatment ◽

Cell Counts ◽

Cd4 Cell Counts ◽

Immunodeficiency Virus ◽

Positive Sputum Smear

Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection poses a growing clinical challenge. People living with HIV have a higher chance of developing TB, and once the disease has progressed, are at greater risk of having unfavorable TB treatment outcomes. Data on TB treatment outcomes among the HIV-associated TB population in Uzbekistan are limited. Thus, we conducted a cohort study among 808 adult patients with HIV-associated TB registered at the Tashkent TB referral hospital from 2013–2017 to document baseline characteristics and evaluate risk factors for unfavorable TB treatment outcomes. The data were collected from medical records and ambulatory cards. About 79.8% of the study population had favorable treatment outcomes. Antiretroviral therapy (ART) coverage at the admission was 26.9%. Information on CD4-cell counts and viral loads were largely missing. Having extrapulmonary TB (aOR 2.21, 95% CI: 1.38–3.53, p = 0.001), positive sputum smear laboratory results on admission (aOR 1.62, 95% CI: 1.07–2.40), diabetes (aOR 5.16, 95% CI: 1.77–14.98), and hepatitis C (aOR 1.68, 95% CI: 1.14–2.46) were independent risk factors for developing unfavorable TB treatment outcomes. The study findings provide evidence for targeted clinical management in co-infected patients with risk factors. Strengthening the integration of TB/HIV services may improve availability of key data to improve co-infection management.

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Risk factors for human immunodeficiency virus infection in intravenous drug users

Journal of Clinical Psychopharmacology ◽

10.1097/00004714-199002000-00019 ◽

1990 ◽

Vol 10 (1) ◽

pp. 63

Author(s):

E E Schoenbaum ◽

D Hartel ◽

P A Selwyn ◽

R S Klein ◽

K Davenny ◽

...

Keyword(s):

Risk Factors ◽

Human Immunodeficiency Virus ◽

Virus Infection ◽

Human Immunodeficiency Virus Infection ◽

Drug Users ◽

Intravenous Drug ◽

Intravenous Drug Users ◽

Immunodeficiency Virus

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Situational and Sociodemographic Characteristics of Children Infected With Human Immunodeficiency Virus From Pediatric Sexual Abuse

PEDIATRICS ◽

10.1542/peds.91.1.39 ◽

1993 ◽

Vol 91 (1) ◽

pp. 39-44

Author(s):

George A. Gellert ◽

Michael J. Durfee ◽

Carol D. Berkowitz ◽

Kathleen V. Higgins ◽

Vincent C. Tubiolo

Keyword(s):

Risk Factors ◽

Human Immunodeficiency Virus ◽

Sexual Abuse ◽

High Risk ◽

Hiv Infection ◽

Sociodemographic Characteristics ◽

Antibody Testing ◽

Immunodeficiency Virus ◽

Hiv Antibody Testing ◽

Hiv Seropositive

This study assessed the situational and sociodemographic characteristics of children infected with human immunodeficiency virus (HIV) from pediatric sexual abuse. A letter of inquiry was sent to 2147 professionals across health and social service disciplines involved with child abuse assessment, treatment, and prevention. Respondents working in programs where HIV antibody testing of abuse victims occurs and who had identified HIV infection in one or more abused children were sent a survey to assess the demographics of victims, the family/living situation where abuse occurred, alternative risks for HIV infection, bases for diagnosis of sexual abuse and for HIV antibody testing, and profiles of the perpetrator and type of abuse. Of 5622 estimated HIV antibody tests conducted during 113 198 sex abuse assessments, 28 children were infected with HIV and lacked any alternative transmission route to that of sexual abuse. A total of 41 HIV-infected children with a history of sexual abuse were identified. Thirteen cases had alternative risk factors and were excluded from analysis. Sixty-four percent of the 28 victims with sexual abuse as the sole risk factor were female and 71% were African-American. The mean age was 9 years. Coinfection with another sexually transmitted disease (STD) occurred in 9 (33%) cases. Sexual abuse was diagnosed on the basis of a victim disclosure in 21 (75%) cases. The basis for HIV antibody testing was physical findings suggestive of HIV infection in 9 (32%) cases, HIV-seropositive or high-risk perpetrator in 6 (21%) and 2 (7%) cases, respectively, and the presence of another STD in the victim in 4 (14%) cases. Perpetrators were a child's parent in 10 (42%) cases and another relative in 6 (25%) cases. Perpetrators had behavioral risk factors for or signs/symptoms of HIV infection in 14 (58%) cases. The serostatus of perpetrators was known at time of abuse assessment in 16 (67%) cases and all were seropositive. Duration and form of abusive acts were variable, with 3 victims reporting a single episode and 13 (68%) reporting 6 or more episodes. Penile vaginal and/or rectal penetration was reported in only 50% of cases. It is concluded that sexual abuse must be considered as a potential, although infrequent, mode of transmission of HIV infection in children. Children who have been abused should be evaluated selectively for HIV infection particularly if the perpetrator is known to be HIV seropositive or engages in HIV high-risk behavior, if abuse occurred in a geographic area of high disease prevalence, and if the child has symptoms of HIV infection or another STD. Children who are found to be HIV infected and lack risk factors such as prior transfusion or maternal (perinatal) infection should be assessed for pediatric sexual abuse.

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Risk Factors for Developing Active Tuberculosis After the Treatment of Latent Tuberculosis in Adults Infected With Human Immunodeficiency Virus

Open Forum Infectious Diseases ◽

10.1093/ofid/ofu120 ◽

2015 ◽

Vol 2 (1) ◽

Cited By ~ 12

Author(s):

Kojo Amoakwa ◽

Neil A. Martinson ◽

Lawrence H. Moulton ◽

Grace L. Barnes ◽

Reginah Msandiwa ◽

...

Keyword(s):

Risk Factors ◽

Human Immunodeficiency Virus ◽

Latent Tuberculosis ◽

Preventive Treatment ◽

Preventive Therapy ◽

Active Tuberculosis ◽

Baseline Viral Load ◽

Test Size ◽

Immunodeficiency Virus ◽

Independent Risk Factors

Abstract Tuberculosis is the leading cause of death among adults infected with human immunodeficiency virus (HIV), and rates of tuberculosis remain high even after preventive therapy. Among 908 HIV-infected adults in a trial of preventive treatment, we found self-reported alcohol consumption, low baseline CD4 count, high baseline viral load, and tuberculin skin test size >15 mm as independent risk factors for incident tuberculosis.

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